The use of rhythmic auditory stimulation for functional gait disorder: A case report.

Functional neurological disorder (FND) functional gait disorder gait training neurologic music therapy (NMT) rhythmic auditory stimulation (RAS)

Journal

NeuroRehabilitation
ISSN: 1878-6448
Titre abrégé: NeuroRehabilitation
Pays: Netherlands
ID NLM: 9113791

Informations de publication

Date de publication:
2022
Historique:
pubmed: 26 2 2022
medline: 1 4 2022
entrez: 25 2 2022
Statut: ppublish

Résumé

Functional gait disorders (FGD) are a common and disabling condition. Consensus-based rehabilitation techniques for treating FGD and other functional neurological disorder presentations at large utilize a variety of therapeutic strategies, including distraction, novel approaches to movement, entrainment, stress/hypervigilance modulation, and psychotherapy. Here we present a case of a 24-year-old woman with a complex history of anxiety, depression, left frontal astrocytoma, postural orthostatic tachycardia syndrome (POTS) and FGD. During a multidisciplinary inpatient rehabilitation stay for FGD, the patient underwent rhythmic auditory stimulation (RAS) delivered by a neurologic music therapist in conjunction with physical therapy, occupational therapy, and psychotherapy. The RAS intervention appeared to play a significant role in symptom resolution for this patient. Improvement in the patient's truncal displacement, foot dragging, and well as overall gait speed occurred following serial RAS trials performed over a single treatment session. Benefits persisted immediately following the intervention and upon subsequent reassessment. Although at four-year follow-up the patient's FGD symptoms remained resolved, fatigue continued to limit her ambulatory capacity and overall endurance. RAS represents a unique therapeutic approach for treating FGD, complementary to existing consensus-based rehabilitation recommendations, and may warrant further consideration by the field.

Sections du résumé

BACKGROUND BACKGROUND
Functional gait disorders (FGD) are a common and disabling condition. Consensus-based rehabilitation techniques for treating FGD and other functional neurological disorder presentations at large utilize a variety of therapeutic strategies, including distraction, novel approaches to movement, entrainment, stress/hypervigilance modulation, and psychotherapy.
CASE REPORT METHODS
Here we present a case of a 24-year-old woman with a complex history of anxiety, depression, left frontal astrocytoma, postural orthostatic tachycardia syndrome (POTS) and FGD. During a multidisciplinary inpatient rehabilitation stay for FGD, the patient underwent rhythmic auditory stimulation (RAS) delivered by a neurologic music therapist in conjunction with physical therapy, occupational therapy, and psychotherapy.
RESULTS RESULTS
The RAS intervention appeared to play a significant role in symptom resolution for this patient. Improvement in the patient's truncal displacement, foot dragging, and well as overall gait speed occurred following serial RAS trials performed over a single treatment session. Benefits persisted immediately following the intervention and upon subsequent reassessment. Although at four-year follow-up the patient's FGD symptoms remained resolved, fatigue continued to limit her ambulatory capacity and overall endurance.
CONCLUSION CONCLUSIONS
RAS represents a unique therapeutic approach for treating FGD, complementary to existing consensus-based rehabilitation recommendations, and may warrant further consideration by the field.

Identifiants

pubmed: 35213331
pii: NRE228005
doi: 10.3233/NRE-228005
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

219-229

Auteurs

Caitlin Hebb (C)

MedRhythms, Inc., Boston, MA, USA.
Spaulding Rehabilitation Hospital, Boston, MA, USA.

Geoffrey Raynor (G)

Department of Psychiatry, Brigham's and Women's Hospital, Boston, MA, USA.

David L Perez (DL)

Department of Neurology and Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Jill Nappi-Kaehler (J)

Wingate University, Wingate, NC, USA.

Ginger Polich (G)

Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Brigham's and Women's Hospital, Boston, MA, USA.

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Classifications MeSH